| NPI | 1760012660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLY KING Owner 361-960-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2023-10-18 |